CMV-specific T Cell Immunity Test Indicated Prophylaxis of Letermovir After All-HSCT
CMV-specific T Cell Immunity Test Indicated Prophylaxis of Letermovir After Allogeneic Hematopoietic Stem Cell Transplantation
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Reactivation of cytomegalovirus (CMV) leads to significant morbidity and mortality following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Letermovir (LTV) has substantially reduced the risk of clinically significant CMV infection (csCMVi) in CMV seropositive recipients of allo-HSCT. LTV discontinuation after day 100 (d100) has been reported to increase the risk of late-onset csCMVi, causing by impaired reconstitution of CMV-specific T immunity. The investigator sought to decrease the probability of CS-CMVi after letermovir withdrawal. Restoration of CMV-specific T cells is imperative for effective control of CMV reactivation following allo-HSCT. Letermovir has been found impending recovery of CMV-specific T immunity. The investigators' retrospective study has proved that lower CMV-specific CD4+ T cells (<2.01 cells/µL) at week 8 increased the risk of late-onset CMV reactivation (50.0%) compared to the higher ones (7.69%, p=0.04) in letermovir prophylaxis. Thus, the guidance of CMV-specific cell immunity is recommended in letermovir prophylaxis.
Therefore, the investigator conduct a multicenter, randomized, controlled study based on retrospective research to further explore and validate the efficacy of CMV-specific T cell immunity test guiding the prolonged usage of letermovir.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Xiaoxia Hu
- Phone Number: +86-021-64370045
- Email: lulukk326@163.com
Study Locations
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Shanghai, China
- Ruijin Hospital, Shanghai Jiaotong University School of Medicine
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Shanghai, China
- Shanghai Liquan Hospital
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Hubei
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Wuhan, Hubei, China
- Tongji Hospital of Huazhong University of Science and Technology, Wuhan
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Shanghai Municipality
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Shanghai, Shanghai Municipality, China
- Ruijin Hospital of Shanghai Jiaotong University
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Zhejiang
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Hangzhou, Zhejiang, China
- The First Hospital of Zhejiang University School of Medicine
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- first allogeneic hematopoietic stem cell transplantation;
- 18-70 years old;
- use cytomegalovirus prophylaxis with letemovir after allo-HSCT;
- CMV Ig G D+/R+;
Exclusion Criteria:
- Allergy, known hypersensitivity to letermovir tablet or injection components;
- CMV DNAemia within six months before transplantation or previous CMV disease;
- Presence of organ failure and inability to tolerate allogeneic hematopoietic stem cell transplantation;
- Second transplantation;
- Combination of immunodeficiency diseases;
- Those judged by the investigator to be unsuitable for participation in this trial.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: CMI-F
Letemovir prophylaxis stops when CMV-FlowSpot >1.5.
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letermovir stops when CMI>1.5
|
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Other: CMI-N
Letemovir prophylaxis stopos in the first 100 days after allo-HSCT.
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letermovir stops when CMI>1.5
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of late-onset clinical significant CMV (cs-CMV) infection
Time Frame: through study completion, an average of 1 year
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Incidence of late-onset clinical significant CMV (cs-CMV) infection
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through study completion, an average of 1 year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
overall survival
Time Frame: through study completion, an average of 1 year
|
overall survival
|
through study completion, an average of 1 year
|
|
cumulative incidence of cs-CMV infection
Time Frame: through study completion, an average of 1 year
|
cumulative incidence of cs-CMV infection
|
through study completion, an average of 1 year
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- RJBMT-2024-02
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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